1. Pelvic vascular injuries
MH SIKHOSANA

2. anatomy

3. Mechanisms of injury Penetrating - stabs - gunshot Blunt - MVA - fall
- crush

4. Penetrating injuries Common iliac and external should be repaired
Internal iliac is usually ligated
All the pelvic veins can be ligated

5. Blunt trauma Unstable patient and transient responders
Stable and the responders

8. Retroperitoneal Haematoma

9. Unstable patient After pelvic binder and bolus fluid
Permissive hypotensive strategy
Blood and clotting factors instead of large volumes of crystalloids
OT stat for haemorrhage control

10. Unstable pelvis
Open book fractures and vertical shear pattern are associated with vascular injuries
No attempts should be made to show pelvic instability
Binder will help with the bone ends bleeds and the venous not ARTERIAL

11. Unstable patient in thearte
Venous bleeds- ligation and extra peritoneal packing
Arterial – repair CIA and EIA and ligate the IIA
- branches of the IIA- packing and angio suite for embolisation

12. Pelvic Packing

13. Stable and the responders
CTA to identify the vascular injury
- venous  continue with the pelvic binder
- arterial – internal iliac and its branches  embolization
- minor CIA and EIA injuries- stent, major open surgery

14. Management

15. THANK
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